Organization
WELLSPRING FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN L RILES JR. M.D. (DOCTOR)
(757) 312-0166
Entity
Organization
Contact information
Practice address
648 INDEPENDENCE PKWY, SUITE 300, CHESAPEAKE, VA 23320-5206
(757) 312-0166
(757) 312-8116
Mailing address
648 INDEPENDENCE PKWY, SUITE 300, CHESAPEAKE, VA 23320-5206
(757) 312-0166
(757) 312-8116
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101044787
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101044787
STATE LICENSE
VA
Enumeration date
04/16/2007
Last updated
08/22/2020
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